Modern Pediatrics. Ukraine

Nasal congestion in infants and children of different ages

A.L. Kosakovskyi — 2025-04-28

Nasal congestion in childhood is a common complaint and clinical symptom, and the diagnosis and treatment of the conditions that cause this symptom vary significantly depending on age. Newborns are necessarily nasal breathers, so difficulty in nasal breathing is a very important symptom that must be evaluated for timely correction.

Аim - to analyze scientific literature sources regarding the causes, consequences, and modern views on the correction and prevention of nasal breathing disorders.

The authors present and systematize information on the main causes of nasal congestion in infants and children of different ages. The focus is on the causes and consequences of nasal breathing disorders in children. From the standpoint of modern international recommendations, the effectiveness of correction of nasal breathing disorders is assessed and views on the possibilities of preventing upper respiratory tract diseases are expanded.

Conclusions. The nasal mucosa in young children requires regular care. Nasal obstruction in childhood is a common problem, which often leads to negative consequences. The use of the new medical product SNOTTY (CHOTTI) allows for high-quality and effective cleansing of the nasal mucosa from nasal secretions, removal of nasal congestion with difficulty in nasal breathing, and provision of daily hygiene of the nasal cavity.

The authors declare no conflict of interest.

Cardonate Kiddy in pediatric practice

D.S. Khapchenkova — 2025-04-28

Considering the modern living conditions of children in Ukraine (chronic stress, unbalanced nutrition, prolonged stays in bomb shelters, increased screen time due to remote learning), the question arises regarding the necessity to enhance the natural adaptive capabilities of the body by adding dietary supplements to the diet to improve the health of the country's child population.

Aim - to present the dietary supplement «Cardonate Kiddy» as an example of a combined metabolic drug for children from 3 years old.

The dietary supplement «Cardonate Kiddy» can be used as an additional source of amino acids carnitine, lysine and cysteine in combination with B vitamins and minerals: zinc, iodine, selenium in order to increase the adaptive capabilities and general reactivity of the body, to maintain the normal functioning of the cardiovascular and nervous systems, normal cognitive function of the brain, increase endurance under increased physical and psycho-emotional stress, during the period of convalescence after illnesses, asthenic conditions of various origins, poor appetite, underweight, to reduce fatigue and fatigue, protect the cell from oxidative stress.

The research was carried out in accordance with the principles of the Helsinki Declaration.

No conflict of interest was declared by the author.

Modern approaches and practices for assessing neonatal pain (literature review)

M.L. Aryayev — 2025-04-28

Pain experienced during the neonatal period may have long-term consequences for a child’s physical, mental, and emotional development, justifying the need for accurate pain assessment and effective management of pain syndromes. The study explores various approaches to identifying pain in newborns, particularly in preterm infants, who exhibit heightened sensitivity to painful stimuli due to the immaturity of their nervous system.

The aim - to analyze scientific data on the causes of development, clinical manifestations and current practices of pain assessment in newborns.

The article analyzes pain assessment methods, including subjective and objective scales such as N-PASS, NIPS, CRIES, COMFORTneo, and PIPP-R. Challenges in standardizing these tools, driven by individual variations in neonatal responses, are discussed. The impact of pain on physiological parameters, such as heart rate, blood pressure, and oxygen saturation, as well as on behavioral manifestations, including crying and facial expressions, and neurodevelopment, is examined, supported by findings from recent studies.

Advanced technologies for pain assessment, including biobehavioral methods such as heart rate variability analysis, electroencephalography, and near-infrared spectroscopy, are reviewed. Non-pharmacological pain management strategies, such as breastfeeding, the Kangaroo Mother Care method, and sucrose administration, are described, alongside pharmacological approaches, including the use of opioids and local anesthetics. The article also addresses ethical considerations and the importance of a multidisciplinary approach to caring for newborns undergoing painful procedures. The need for ongoing training of healthcare professionals and updates to clinical protocols to enhance the quality of care is outlined.

Conclusion.Effective pain management is impossible without timely and accurate pain assessment. To implement modern methods and approaches, it is necessary to constantly improve the qualifications of medical professionals, update clinical protocols, and ensure access to the latest diagnostic tools.

The authors declare no conflict of interest.

The potential of stem cells in the treatment of neonatal hypoxic-ischemic encephalopathy

T.I. Savrun — 2025-04-28

Aim - to investigate the potential of stem cells in the treatment of neonatal encephalopathy, focusing on a systematic review of current scientific sources.

The review included articles published from 2010 to 2024, which highlight the effectiveness and safety of mesenchymal, induced pluripotent and neural stem cells in the treatment of hypoxic-ischemic encephalopathy. The PRISMA methodology ensured transparency and replicability of the analysis. The results confirm the high effectiveness of mesenchymal stem cells, which demonstrate anti-inflammatory, immunomodulatory properties and promote neurogenesis. Induced pluripotent cells are promising due to their ability to multilineage differentiation, although their use is limited by ethical aspects. The choice of the method of cell administration significantly affects the results: intravenous administration is safe but less precise, intracerebroventricular provides maximum effectiveness, while the intranasal method is becoming popular due to the possibility of avoiding systemic complications.

Stem cell therapy combined with hypothermia has shown a synergistic effect, opening new prospects for the treatment of neurodegenerative diseases.

The authors declare the absence of a conflict of interest.

Biliary dyskinesia in сhildren

V.I. Bobrova — 2025-04-28

Biliary dyskinesia in children is a rather controversial diagnosis in the pediatric population, as there are no standardized pediatric diagnostic criteria and treatment.

Аim - to summarize data from the literature regarding risk factors, clinical manifestations, diagnosis, and treatment of biliary dyskinesia in children.

This article presents an overview of current diagnostic strategies and treatment outcomes using both surgical and non-surgical approaches. The only diagnostic method for biliary dyskinesia in both adults and children is cholecystokinin-stimulated cholecyntygraphy. At the same time, there is no standard, validated method for assessing gallbladder motility in children. Despite the lack of high-quality evidence supporting this practice, cholecystectomy remains a commonly used treatment method. The outcomes regarding the prognostic value of medical treatment have been evaluated in studies with small sample sizes, and none of them has been accepted as the "gold standard" of therapy.

Conclusions. The diagnosis and treatment of biliary dyskinesia are challenging due to the combination of vague and diverse symptoms and the absence of definitive, unified diagnostic criteria in the pediatric population.

The authors declare no conflict of interest.

Psychological and social aspects of the value attitude of adolescents aged 11-14 to health care

O.P. Hryshchenko — 2025-04-28

Preservation of the health of adolescents aged 11-14 is the basis of the health of the nation. Strengthening the mental, psychological, social and physical health of adolescents aged 11-14 is due to the need to implement effective mechanisms for the prevention of chronic non-communicable diseases, which have become the main cause of premature mortality of children; the low level of involvement of adolescents in informing about their own health in particular and the psychological and social aspects of the value attitude to health in general; the availability of scientific research results that substantiate the influence of a health-preserving educational environment on the formation of healthy habits in adolescence (physical activity in combination with a balanced diet, the fight against harmful habits and improving the ecological environment).

Аim - to conduct a systematic analysis of scientific sources on the psychological and social aspects of the value attitude of adolescents aged 11-14 to health preservation.

Research into the psychological and social aspects of involving adolescents in the formation of a value-based attitude towards health preservation requires the creation of favorable conditions in secondary education institutions to actively assist in the formation of positive behavioral and emotional skills in the process of integrating health-saving technologies into education. Scientists note that maintaining a healthy lifestyle by adolescents aged 11-14 is the basis for preserving and strengthening health. The problem of forming a value-based attitude of adolescents aged 11-14 to health preservation is becoming an important direction in the development of the educational system of a modern school, the goal of which is physical, mental, social health and the formation of useful habits. The actualization of the subjectivity of adolescents in preserving and strengthening their own health is a medical and social problem of today.

The authors declare the absence of a conflict of interest.

Mental health as a component of a healthy lifestyle of Ukrainian adolescents aged 15-16 years under martial law

T.V. Doroshenko — 2025-04-28

Аim - to conduct a systematic analysis of scientific sources that investigate mental health as a component of a healthy lifestyle of Ukrainian adolescents aged 15-16 years in conditions of martial law.

Ensuring the mental health of adolescents in conditions of martial law is an important problem for modern Ukraine. Adolescence is a transitional stage between childhood and adulthood. According to the terminology used by the UN, adolescents are persons aged 10-19 years (early adolescence - 10-14 years; late adolescence - 15-19 years). Adolescents aged 15-16 years need to create an effective support system at the level of educational programs on mental health and practical self-help tools to maintain their own mental health during war, which will include access to psychological help, psychotherapy and preventive measures. Mental health is a state of well-being in which an adolescent is able to realize his or her potential, cope with the stresses of everyday life, study productively, work and contribute to society. And war has long-term negative consequences for adolescents aged 15-16 years.

Informing and popularizing the care of adolescents and young people for their own mental health is a key aspect in maintaining resilience and adaptability during full-scale military operations. Adolescents aged 15-16 years face powerful psychological pressure caused by chronic stress, traumatic events, loss of loved ones and a constant threat to their safety and their own lives. This situation contributes to the development of serious mental health problems. The issue of the impact of martial law on the mental health of adolescents remains relevant.

The authors declare the absence of a conflict of interest.

Characteristics of the epidemic process of pertussis in Ukraine against the COVID-19 pandemic and martial law

V.I. Zadorozhna — 2025-04-28

In 1998, the World Health Assembly set a goal to reduce the incidence of pertussis to 1 case per 100,000 population. This target has not been achieved, and after the COVID-19 pandemic, the epidemic situation with pertussis has become more complicated for Ukraine and many countries.

The aim is to determine the epidemiological features of pertussis in Ukraine, taking into account the impact of the COVID-19 pandemic and martial law.

Materials and methods. The incidence of pertussis in Ukraine, its structure by age and territory, and vaccination coverage data were analyzed. A complex of epidemiological methods combined with mathematical statistics was applied.

Results and conclusions. After a sharp decrease in the incidence of pertussis in Ukraine against the backdrop of the COVID-19 pandemic in 2021-2022, it increased sharply in 2023-2024, which was complicated by martial law. A similar trend was observed in many other countries. The highest incidence rates were observed among children of the first year of life (362.15 per 100 thousand) and aged 1-4 years (114.13). This requires the introduction of revaccination against pertussis in children aged 6 years. During the epidemic upsurge in 2023-2024 the largest proportion of cases occurred in the western regions of Ukraine (73.8% and 53.4%, respectively), which were most involved in wartime migration processes and where vaccination coverage levels were low in previous years. The problem of pertussis losing the character of a vaccine-controlled infection requires further study, in particular, taking into account changes in the biological properties of Bordetella pertussis against the background of long-term vaccine prophylaxis.

Diagnostic and prognostic value of markers UCH-L1 and NEFL for brain injury in premature infants

V.O. Vlasenko — 2025-04-28

Preterm birth is a significant risk factor for central nervous system damage. The use of biomarkers in neonatal clinical practice may help to reduce the need for multiple invasive procedures and enable timely treatment and early preventive interventions. UCH-L1 is a neuron-specific enzyme that indicates acute neuronal injury, while NEFL is a peptide reflecting axonal damage that correlates with long-term neurological outcomes. The application of these biomarkers has the potential to optimize the management of preterm infants and improve prognostic accuracy.

Aim - to determine the diagnostic and prognostic value of serum UCH-L1 and NEFL levels in preterm infants with brain injury.

Materials and methods. The study included 69 newborns, divided into three groups: group 1 (n=20): preterm infants with sepsis and brain injury; group 2 (n=25): preterm infants with hypoxic-ischemic brain injury; control group (n=24): healthy full-term newborns. Serum levels of UCH-L1 and NEFL were measured in all participants using enzyme-linked immunosorbent assay. Sensitivity, specificity, and cut-off values of the biomarkers were assessed using ROC analysis.

Results. The neonatal period was significantly more complicated in the group 1 infants. Neurological status in the both groups was characterized by brain edema, intraventricular hemorrhage, and seizures, with a significantly higher prevalence in the group 1. Blood levels of UCH-L1 and NEFL in the groups 1 and 2 were significantly higher than in the control group. ROC analysis confirmed a high diagnostic potential of UCH-L1 in identifying brain injury in preterm infants. An optimal cut-off value of UCH-L1 (112.65 pg/mL) demonstrated high sensitivity (94.7%) and specificity (85.7%) for diagnosing brain injury in preterm newborns. NEFL showed the highest accuracy in detecting severe brain injury.

Conclusions. UCH-L1 is a highly sensitive biomarker for the early diagnosis of brain injury in preterm infants. NEFL may serve as an additional marker, particularly useful for identifying severe forms of brain injury.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. Informed consent was obtained from patients (parents of children or their guardians).

The author declares no conflict of interest.

Endothelial dysfunction in children with SARS-CoV-2-associated pneumonia and its dependence on the activity of the infectious-inflammatory process

V.M. Dudnyk — 2025-04-28

One of the key pathogenetic mechanisms of COVID-19 is endothelial dysfunction, which enhances prothrombotic phenomena, endotheliitis, and multiorgan immunothrombosis. The mechanisms of endothelial damage in children remain insufficiently studied.

Aim: to determine the levels of endothelial dysfunction in children with SARS-CoV-2-associated pneumonia and to analyze its relationships with clinical and laboratory indicators of the activity of the infectious and inflammatory process.

Materials and methods. The Main group consisted of 160 children with SARS-CoV-2-associated pneumonia and 40 healthy children (Control group). The Main group was divided depending on gender, age, disease severity, levels of C-reactive protein (CRP), and procalcitonin. To assess endothelial dysfunction, the level of endothelin-1 and vascular endothelial growth factor (VEGF) in blood serum was determined.

Results. The values of VEGF and endothelin-1 were the highest in patients with severe pneumonia. The values of laboratory markers of endothelial dysfunction were significantly higher with higher levels of CRP in children of the Main group by 31.95% and 33.14% for endothelin-1 and VEGF, respectively. A positive medium-strength relationship was established between the values of fibrinogen and CRP with VEGF levels; a weak positive relationship between the levels of VEGF and procalcitonin; fibrinogen and endothelin-1 levels. A probable medium-strength positive relationship was established between the values of endothelin-1 and VEGF, with the levels of interleukins (IL) 1, 6.

Conclusions Children of the Main group have endothelial dysfunction, as evidenced by increased levels of endothelin-1 and VEGF. These values were associated with disease severity, CRP levels, and gender. VEGF levels were highest in patients with severe pneumonia. There was a moderate positive association between laboratory markers of endothelial dysfunction, such as endothelin-1

Fetal anatomical variability of the stomach

T.V. Khmara — 2025-04-28

The rapid development of fetal surgery and insufficient study of the variability of the shape, size, and topography of the stomach in fetuses determine the relevance of studying the anatomical features of this organ for improving the diagnosis and surgical correction of congenital defects.

Аim - to study the anatomical variability of the human fetal stomach at 4–10 months in order to accurately distinguish between normal and pathological development, improve prenatal diagnostics, and aid in planning neonatal surgical interventions.

Material and methods. The material for the study was preparations of 70 cadavers of human fetuses of both sexes with a parietal-coccygeal length of 81.0-375.0 mm, which was studied using macropreparation, radiography, morphometry, and statistical data processing methods.

Results. In the studied human fetuses, the stomach is completely located to the left of the median plane. The angle between the esophagus and the lesser curvature of the stomach is within 155-190°. In human fetuses, the stomach is completely located to the left of the median plane, mainly vertically at the level of the X thoracic - I-II lumbar vertebrae. At the end of the fetal period of human ontogenesis, a change in the skeletotropic level of the stomach occurs - its displacement in the caudal direction to the height of one vertebra. In late human fetuses, the folding of the gastric mucosa is well expressed.

Conclusions. In human fetuses, the following varieties of the stomach shape have been identified: flask-shaped (in the form of a retort) - 56% of cases, horn-shaped (20% of observations), funnel-shaped (14% of fetuses), sac-shaped (10%), rounded (8%) or slightly elongated (2%). During the second half of human intrauterine life, the stomach undergoes intensive development, the dimensions of which increase by 2.1-2.4 times.

The study was conducted in accordance with international and national bioethical standards, which was confirmed by the conclusion of the Biomedical Ethics Commission of the Bukovinian State Medical University.

The authors declare no conflict of interest.

Immunological and apoptotic disturbances in children with congenital heart defects: pathogenetic aspects and diagnostic significance

L.V. Mammadova — 2025-04-28

The aim of this study was to investigate immunological and apoptotic markers in children with congenital heart defects (CHDs) in order to assess their pathogenetic role and diagnostic significance.

Material and methods. A total of 114 children were enrolled and divided into three groups: patients with acyanotic CHDs (n=63), patients with cyanotic CHDs (n=28), and a control group of healthy children (n=23). All participants were evaluated for levels of CD3+, CD4+, CD8+, CD19+, CD16/56+, HLA-DR+, and CD95+ lymphocytes, as well as serum concentrations of IL-6 and TNF-α.

The results revealed significant differences between the clinical groups. Children with cyanotic CHDs demonstrated a marked decrease in CD3, CD4, and CD8 levels, along with a substantial increase in CD95 expression and pro-inflammatory cytokines, particularly TNF-α and IL-6 (p<0.01). These changes indicate immune system activation and enhanced apoptosis in the setting of chronic hypoxia.

Conclusion. Our findings confirm the pathogenetic relevance of immune and apoptotic disturbances in CHDs and highlight their potential diagnostic value.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. The informed consent was obtained from patients.

The authors declare no conflict of interest.

Features of the course of primary selective immunoglobulin A deficiency in children

T.V. Pochynok — 2025-04-28

Immunoglobulin A is a key component of mucosal immunity and plays a crucial role in protecting the mucous membranes of the respiratory, gastrointestinal, and genitourinary systems. Selective IgA deficiency is the most common primary immunodeficiency in children, yet it often remains undiagnosed due to mild or absent clinical symptoms. However, the presence of IgA deficiency in children with recurrent infections can significantly influence the course of disease and may require adjustments in clinical management.

Aim - to determine the prevalence of selective IgA deficiency in children with frequent respiratory infections and to analyze their clinical features.

Materials and methods. A total of 98 children (50 girls and 48 boys), aged 4-14 years, with frequent respiratory infections were examined. Serum IgA levels were measured to detect selective deficiency. The study was conducted in accordance with the ethical standards of the Declaration of Helsinki, and informed parental consent was obtained for each participant.

Results. Selective IgA deficiency was identified in 19 children (11 boys and 8 girls), accounting for 18.6% of the study population. These patients more frequently presented with recurrent infections and had a more severe course of disease.

Conclusions. Although selective IgA deficiency is asymptomatic in most cases, it may be associated with the development of severe pathological conditions in children, including recurrent respiratory infections, allergic disorders, and autoimmune diseases. Detecting selective IgA deficiency in pediatric practice is essential for early diagnosis and timely management of related conditions. Pediatricians and immunologists should aim to identify the pathophysiological links between secretory IgA deficiency and various clinical manifestations to develop individualized monitoring and treatment strategies for affected children.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for participant. Informed consent was obtained from patients.

The authors declare no conflict of interest.

Association between plasma surfactant proteins A and D levels and types of respiratory therapy in preterm neonates

İ.A. Mirzayeva — 2025-04-28

Surfactant proteins A (SP-A) and D (SP-D) are key components of the pulmonary surfactant system and play important roles in lung immunity and homeostasis. Their plasma levels may reflect pulmonary maturity and disease severity in preterm neonates.

Aim: to evaluate the association between plasma levels of SP-A and SP-D and the type of respiratory therapy administered to preterm neonates.

Material and methods. A total of 114 preterm neonates treated in multiple neonatal intensive care units (NICUs) were categorized based on initial respiratory support - non-invasive (e.g., CPAP, NIPPV) or invasive ventilation. Plasma SP-A and SP-D levels were measured using ELISA. The statistical analysis was performed to assess correlations with therapy type, diagnosis, and outcomes.

Results. Of the neonates initially managed with non-invasive therapy, 60.6% required escalation to invasive ventilation. Plasma SP-A and SP-D levels were significantly higher in those requiring invasive support compared to those maintained on non-invasive therapy. Repeated surfactant dosing and lower APGAR scores were also associated with elevated protein levels and escalation therapy. Although trends were observed in the group initially receiving invasive ventilation, statistical significance was limited by the small sample size.

Conclusion. Elevated plasma SP-A and SP-D levels are associated with an increased need for invasive respiratory support in preterm neonates. These proteins may serve as useful biomarkers for predicting respiratory therapy needs and monitoring treatment responses. Further large-scale studies are needed to validate their clinical utility.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.

Transplant surgeon’s strategies in cases of cholestatic jaundice in children of the first months of life

H.V. Kurylo — 2025-04-28

Aim. To study the features of differential diagnosis of cholestatic jaundice in children of the first months of life, the terms and methods of conservative and/or surgical treatment before the development of irreversible cirrhotic changes in the liver.

Materials and methods. The object of the study was 274 children aged 1 to 8.5 months with clinical, biochemical, instrumental signs of hepatobiliary pathology against the background of delayed physical and neuropsychiatric development. The research methods included, in addition to general clinical, instrumental, determination of markers of genetic diseases, viral hepatitis, TORCH infections; histological studies of liver biopsies, multidisciplinary consultations.

Results. During the examination of children, the following results were obtained: Bayler's disease and syndrome - 2, Alazhil syndrome - 4, tyrosinemia - 1, α1-antitrypsin deficiency - 1, Caroli's disease - 1, galactosemia - 1, extrahepatic choledochal cysts - 2, biliary atresia (BA) - 56, neonatal hepatitis - 186 children. Against the background of treatment (conservative and surgical), biochemical and clinical indicators improved or normalized. In some orphan diseases, liver transplantation (LT) in seven children ensured a full-fledged quality of life. The term of surgical interventions (Kasai operation, LT) in cases of BA was up to 60 days of life. The volume of surgical interventions depended on the form and type of BA, indications for LT. LT was performed in 37 children with BA. Three children with cholestatic hepatitis died due to concomitant multiple congenital malformations and critical congenital malformations of the heart and large vessels.

Conclusions. Diagnosis of metabolic hereditary orphan cholestatic diseases should begin with neonatal screening, but at present it is not available for all these diseases in Ukraine. Therefore, even before the age of 1 month, orphan diseases with cholestasis should be diagnosed. LT is indicated for patients in whom the cholestatic process is diagnosed late, in case of recurrent cholangitis after KO, and in the presence of a threat of multiorgan failure.

The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee. Informed consent was obtained from the children's parents for the study.

The author declares that there is no conflict of interest.

A challenging diagnosis of hereditary microspherocytosis (Minkowski-Chauffard disease) in a child (a case report)

L.I. Vakulenko — 2025-04-28

Hereditary microspherocytosis (HM) is an inherited hemolytic anemia associated with erythrocyte membrane abnormalities which should be suspected in patients with a triad of symptoms: anemia, jaundice, and splenomegaly. The distinct clinical manifestations may not appear until a certain age, resulting in many undiagnosed mild-to-moderate forms of HM. Although modern technology allows to detect genetic mutations for HM confirmation, many issues remain largely unresolved and need to be addressed.

The aim: to analyze a complex clinical case of HM in a child with a long-term diagnostic stage to raise awareness among physicians about this pathology.

The clinical case of a 17-year-old boy with a clinical diagnosis of “Hereditary microspherocytosis, crisis course, complicated by secondary chronic calculous cholecystitis” was discussed. Clinical and paraclinical findings were analyzed. The medical case describes HM in the boy who presented with the first symptoms of anemia at the age of 3 years, and manifestations of jaundice syndrome with hyperbilirubinemia, hepatomegaly debuted only at the age of 12 years. Such features of the disease course have translated to diagnostic delay of HM and the development of calculous cholecystitis as a complication.

Conclusions. Currently, mild forms of hereditary microspherocytosis are underdiagnosed. Mild and moderately severe course of hereditary microspherocytosis, apart from jaundice and moderate splenomegaly, can be manifested by cutoff hemoglobin values, making it difficult to timely diagnose primary disease and its complications. Since the most common complication of hereditary microspherocytosis is gallstone disease, regular ultrasound examinations of the gallbladder and monitoring of the hepatobiliary system are the best imaging modalities for patients even in the absence of overt hemolysis. In case of conservative therapy ineffectiveness, it is necessary to consider the issue of performing a complete or partial splenectomy, and in the presence of a complication in the form of calculous cholecystitis, it should be combined with cholecystectomy. The analyzed clinical case is a demonstrative example of underdiagnosed mild hereditary microspherocytosis complicated by secondary chronic calculous cholecystitis.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for the study.

The authors have no conflicts of interest to declare.

A clinical case of tricuspid valve damage due to blunt chest trauma in a child

A.A. Malska — 2025-04-28

Traumatic valve lesions in children are extremely rare. As a rule, these are isolated cases associated with high-intensity blunt trauma. Clinical manifestations in the initial period depend on which valve is affected and the severity of its damage and in the vast majority of cases patients may remain asymptomatic for a long time. According to the literature, trauma of the tricuspid valve is the least common.

The aim is to present a clinical case of detachment of the anterior leaflet and papillary muscles of the tricuspid valve in a 6-year-old boy due to a blow to the chest with a horse's hoof.

The article presents a clinical case of damage of the tricuspid valve caused by blunt chest trauma after a horse kick in a 6-year-old boy. During the physical examination, the child showed signs of heart failure: dyspnea, tachycardia, a harsh 3/6 systolic murmur in the tricuspid valve auscultation area, hepatomegaly and severe chest pain. The electrocardiogram showed signs of right ventricular hypertrophy, right atrial enlargement and tachycardia, and a chest X-ray showed mild cardiomegaly. On echocardiographic examination, the diagnosis was confirmed: rupture of tricuspid valve anterior leaflet with papillary muscles and severe tricuspid insufficiency. After the diagnosis was confirmed, the child was transferred to a specialized cardiac surgery center, where tricuspid valve repair was performed urgently. Several clinical cases are presented in the literature in which children had no clinical manifestations immediately after chest trauma, but signs of heart failure developed in coulple months.

Conclusions. Transthoracic echocardiography plays a key role in the diagnosis of valve damage and allows for timely surgical correction. It is important to perform echocardiographic examination of the heart in all children after blunt chest trauma, even in the absence of cardiovascular complaints or clinical signs of heart failure, as intracardiac changes can progress over time and clinical signs can develop in the following months.

The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patients was obtained for the study.

The authors declare no conflict of interest.

Clinical cases of congenital heart defects in children with genetic syndromes

Z.V. Selska — 2025-04-28

Children with genetic syndromes are encountered in the clinical practice of a pediatrician. The complexity of this category of patients lies in the fact that patients often have a severe course of the disease with combined damage to many organs and systems, including often the cardiovascular system, namely the presence of congenital heart defects.

Аim - demonstration of clinical cases of congenital heart defects in children with Down syndrome and DiGeorge syndrome to improve the diagnosis and treatment of cardiovascular pathology in patients with genetic syndromes.

When describing clinical cases in children with Down syndrome and DiGeorge syndrome, a congenital anomaly of the cardiovascular system was detected during routine echocardiography. Early establishment of the main diagnosis and knowledge of the clinical manifestations of these syndromes allowed for the timely detection of concomitant congenital heart defects and the correction of these defects as early as possible.

Conclusions. Timely diagnosis and correction of congenital heart disease in children with genetic syndromes allows for the most positive outcome in the further treatment and management of patients in this category.

The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patients was obtained for the study.

The author declares no conflict of interest.